Category Archives: STFM Blog Competition

How does a little Russian-speaking girl living in a small town south of Moscow come to be a Chief Resident in family medicine at Northwestern in Chicago? Growing up in that small Russian town, I frequently witnessed my grandmother, a pediatrician, step out into late-night blizzards because a patient needed help. Like a year-round Mrs Santa Claus, she would even bundle herself in a sleigh to reach her patients. The entire town spoke highly of how she truly got to know patients and their families. Throughout my journey to and during my medical career, that image of a caring physician remained in my mind: one who believes that a patient is more than his or her illness, and maybe brings a little Mrs Claus-like magic to them, too.

When my parents and I moved to America from Russia, we could only afford to rent one room in a two-bedroom apartment, with a second family living in the other. Even as an enthusiastic little girl getting underfoot in a small space, I noticed my parents immersed themselves in helping others. I watched my mother teach piano ten hours a day and volunteer for every musical event in the community, and witnessed my father walk to graduate school because we couldn’t afford a car but put in extra hours at work when a coworker needed help. Like my grandmother, my parents made me realize that the values of compassion, dedication, and service are what create magical moments.

In high school I spent over 900 hours volunteering at my local hospital, annoying every medical professional who was willing to answer my many questions and discovering my passion for medicine. The summer after my freshman year in the seven-year Honors Program in Medical Education at Northwestern University, I encountered an obstacle I never thought I would face: during a routine appointment, my family medicine physician confirmed some breast masses I had felt. After numerous biopsies, I was diagnosed with a Phyllodes tumor, as well as multiple fibroadenomas. That year, I learned what it is like to experience the medical system from the patient perspective. My encounters with multiple medical professionals taught me about the physician I do and do not want to be. Later that year, after surgery, I finally was given a clean bill of health, and with that came a deep sense of empathy for my future patients and a desire to choose family medicine, a field that focuses on the patient-physician connection and lets me be there for my patients like my family doc was there for me.

On the highway, en route to an important destination, you notice a sea of red before you. Traffic is at a standstill, and you reluctantly take your place in line. Glancing at the clock, then the line of cars inching along, the uneasiness in your stomach grows. Do you trust the GPS telling you to stay the course, or your instincts pulling you toward the next exit? This was exactly the scenario I found myself in 8 years ago. I was in the midst of a successful business career when I realized my desire to improve others’ lives as a physician was more important than any size salary or fancy corner office. I trusted my instincts, took the next exit, and walked away from everything I knew in favor of the unknown winding road before me.

Initially, the angst was distracting; I could only focus on the unfamiliar road itself. I involved myself with causes and positions that felt most comfortable coming from the business world but worried I was letting what seemed to be familiar ‘landmarks’ distract me from what my true route was intended to be. I was identified as a leader amongst my colleagues, university, and community, and was called upon to serve in numerous leadership capacities. It wasn’t until I began to appreciate how I could leverage this to call attention to issues I was passionate about that I realized what an invaluable trait this was for the future leader of a multidisciplinary healthcare team. I began to trust myself and could sense I was headed in the right direction.

At the start of my internal medicine clerkship in medical school, I learned that I had inherited a “difficult patient.” He was 28 years old and had been admitted overnight for hypercalcemia and poorly-controlled sarcoidosis. During sign-out, the overnight resident shared that my “difficult patient”, Mr Johnson, was “non-compliant” with his medications and was threatening to leave against medical advice (AMA). Like a dutiful medical student, I shuffled to Mr Johnson’s room to check in before rounds. Maybe I’d gain some insight and garner some early-rotation good will, I thought. “You’ve done this before,” I reminded myself as I paused outside of room 1354. One swift, sharp breath to steel myself against…I wasn’t sure what. Two knocks and in: “Mr Johnson! I’m Student-Doctor Arnett. How are you this morning?”

Thirty minutes later, the story had shifted and I remember it like it was yesterday. I sat at Mr Johnson’s bedside while he sat slouched on the bed with his legs swung over the side. I don’t know whether it was his familiar eyes that turned down at the corners like my brothers’ or whether it was the pragmatism around the explanation of his life and choices, but I couldn’t for the life of me see Mr Johnson as “difficult.”

Had he skipped months of medications? Sure, but who wouldn’t if, like him, they were affordable. Had he missed his last several primary care and rheumatology visits? Absolutely, but with an understanding of his financial instability, how could he afford his copay? Had he asked to leave AMA before his calcium levels had normalized? “Definitely,” he stated calmly, “and I still plan to.” Mr Johnson shared that he essentially had two full-time jobs. Not only was he a home health aid, but he was also the primary caretaker of his bedridden mother. To complicate matters, his mother had advanced sarcoidosis and insulin-dependent diabetes complicated by kidney failure. If he stayed in the hospital overnight, not only could his home-bound clients miss out on care, but his mother would miss her meals and insulin doses.